Tổng quan tường thuật có yếu tố hệ thống về quy trình kỹ thuật số khép kín trong chế tạo hàm chỉnh hình mũi-xương ổ răng (NAM) cho trẻ sơ sinh bị khe hở môi vòm miệng (CL/P)

Abstract

This narrative review with systematic elements aims to describe and analyze in detail each step of the closed-loop digital workflow for fabricating nasoalveolar molding (NAM) devices in infants with cleft lip and/or palate (CL/P). A literature search was conducted across major electronic databases up to September 2025. Study selection followed the PRISMA flowchart. The core inclusion criterion required studies to fully describe a closed-loop digital workflow for NAM fabrication, from intraoral data acquisition using an intraoral scanner (IOS) to device production. A total of 227 records were initially identified, and after rigorous screening, only 3 studies fully met the criteria for inclusion in this review. The closed-loop digital workflow consists of the following steps: 3D data acquisition using an intraoral scanner, computer-aided design (CAD), computer-aided manufacturing (CAM) via 3D printing or milling, and delivery of the appliance with clinical follow-up. This approach overcomes the inherent airway obstruction risks associated with traditional impression methods and offers advantages in safety, high accuracy (reduced manual error), and time efficiency. The included studies demonstrated positive clinical outcomes with digital NAM appliances, particularly in improving alveolar alignment and nasal morphology. Although preliminary results are promising, the current evidence remains limited in scale and reliability. Multicenter studies with more rigorous designs, cost-effectiveness analyses, and long-term follow-up are needed to clarify the role of the digital workflow in establishing NAM as a standard clinical practice.